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10. <br />I am providing the following items within my booth for the sanitary cleaning of food preparation utensils11. <br />Q Three compartment sink. <br />OR <br />12, <br />13. <br /> I.. <br />"Important** <br />14. <br />Signature Title Date <br />JHealth Permit <br />Pape. Hand Towels, <br />Soap dtspsfissr <br />2 <br />Sawmiwaw WiwWBtw Btetisww Water <br />Pw««f 11 TEMP CV6NT AFP <br />rlnll "lit ■n <br />ice Cooler 1 <br />Sanitaw txEtet- <br />bawruiwowiw <br />modnswi^nadoth. <br />^sSThree deep tubs (basins 6-8 inches minimum)., one for soapy water, one for rinsing and one for a bleach <br />solution (one tablespoon of bleach per gallon of water). <br />Q Detergent, bleach, and wiping cloths (cleaning towels). <br /> Tub to store wiping cloths in bleach solution. <br />n Refrigerator <br />O Ice bath and tubs <br />Booth must be on <br />Concrete. Asphalt. <br />Garbage <br />Can <br />6 G»l Hand wash WasSewute? Conkanw <br />MO Gal. <br />rxSwwhWalw <br />■ <br />II <br />/ Plywood or a Tarp <br />r<? <br />P^6560* *n k00^1 ^ur^n9 k°urs Qf operation; <br />,k. „ xT... ...-. <br />^3 Water supply dispenser with warm water at a minimum of 100°F (i.e. 5-20 gallon container with spigot). <br />One separate tub (bucket or basin) for the collection of rinse/wastewater. <br />c^Paper towels and pump-style soap container. <br />PrepwsTw* <br />I am providing the following cold temperature control for the cold holding of potentially hazardous foods below <br />45’F (if food is used the following day, maintain below 41'F temperature) <br />*&1ce chests <br />D Refrigerated truck <br />□ Other (specify) <br />I am providing the following for adequate hand washing facilities, but separate from utensil wash within my <br />booth: <br />All food vendor booths are subject to inspection. Please make a copy of this application in <br />preparation for this event. A copy of this checklist must be in the booth at all hours of <br />preparation and operation. Return original to festival coordinator three weeks prior to <br />this event ---------- <br />Completed by: z